Tough to make repairs when you don’t know what’s wrong, what parts are needed

It’s getting harder to pretend Manitoba’s health-care capacity crisis is some kind of mystery.

Emergency rooms are jammed, surgical backlogs drag on and diagnostic waits stretch into months. Patients languish in hallways, staff burn out and leave.

Governments respond with the usual flurry of announcements — more hiring, more training seats, more spending — and yet the system never seems to catch up.

Here’s a big reason why: Manitoba doesn’t even have a proper plan for how many health-care workers it needs.

According to a recent freedom of information request, Shared Health — the agency created in 2018 that is mandated to plan the province’s health workforce — has no approved workforce modelling and no forecast of future staffing needs.

None. Not for doctors, not for nurses, not for technologists, not for allied health professionals.

Instead, Manitobans are told a plan is “in development.”

Health human resource planning isn’t some optional, nice-to-have bureaucratic exercise. It’s the foundation of a functioning health-care system. Without it, everything else — recruitment, training, retention, budgeting — is little more than guesswork.

And guesswork is exactly what has landed Manitoba where it is today.

Think about the basic math. Manitoba’s population is growing. It’s also aging. People are living longer, often with more complex, chronic conditions that require ongoing care.

That inevitably drives up demand for physicians, nurses, diagnostic services, home care, long-term care — the entire continuum.

None of this is new. Demographers have been flagging these trends for decades.

Yet somehow, the province’s central health planning body cannot produce a clear, data-driven projection of how many workers will be needed to meet that demand.

When a government boasts about hiring a certain number of nurses or technologists, the obvious question is: how many does the system actually need?

And the answer at the moment is: they don’t know.

If you don’t know how many you actually require — today or five years from now — those numbers are political talking points, not evidence of progress.

It also makes it impossible to know whether shortages are improving or getting worse.

The fragments of data that are available paint a troubling picture. Vacancy rates among technologists and technical assistants are pushing 20 per cent. Nurses are leaving at an alarming rate — by one report, for every 100 nurses gained, 57 departed over roughly a year.

Even more concerning is who is leaving. Mid-career nurses — the backbone of the system, the ones with experience and institutional knowledge — are walking away. As Manitoba Nurses Union president Darlene Jackson has warned, that’s a serious loss that can’t be quickly replaced.

You can train new graduates. You can recruit from elsewhere. But you can’t instantly recreate years of experience.

To be fair, Health Minister Uzoma Asagwara is correct about one thing: workforce planning for more than 55,000 employees across hundreds of roles is complex. There is no one-size-fits-all solution.

But complexity should not be an excuse for inaction.

Other provinces have managed to produce detailed allied health workforce plans. Manitoba, despite having a centralized agency specifically designed to do this work, is still “compiling and analyzing data.”

At some point, that starts to sound less like diligence and more like drift.

The political context doesn’t help. Long-term planning rarely aligns neatly with election cycles. Governments are far more inclined to announce short-term fixes with immediate, visible results than to invest in strategies that may take years to bear fruit.

But health care doesn’t operate on election timelines. It operates on demographic realities.

If Manitoba needs 240 more doctors just to reach the national average — as Doctors Manitoba suggests — that gap didn’t appear overnight. It’s the cumulative result of years of under-planning and underestimating demand.

The same is true across the system.

Shared Health was supposed to fix that. It was created, in part, to bring a provincewide perspective to planning and eliminate the fragmentation that plagued the old regional model. Centralization was sold as a way to better align resources with need.

Without a workforce plan, that promise rings hollow.

What should be in such a plan isn’t a mystery. It should include current vacancy rates, turnover trends, retirement projections, training capacity, graduate retention, population growth forecasts and evolving health needs. It should map out where the gaps are now and where they will be in five, 10 and 20 years.

And it should be public.

Transparency matters. Health-care workers, educators and the public all deserve to see the road map and to hold government accountable for following it.

Right now, there is no road map. Just a system straining under pressure, with too few people trying to do too much work, and no clear sense of when — or if — relief is coming.

So the next time Manitobans wonder why ER waits remain stubbornly high, why surgeries are delayed, why staff seem perpetually stretched thin, the answer isn’t all that complicated.

You can’t meet demand if you haven’t bothered to figure out what demand will be.

tom.brodbeck@freepress.mb.ca